J4 ›› 2010, Vol. 36 ›› Issue (3): 563-567.

• 临床医学 • 上一篇    下一篇

聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎效果评价

 刘元元, 朴荣利, 叶春艳, 牛俊奇   

  1. (吉林大学第一医院二部消化内科,吉林 长春 130031)
  • 收稿日期:2009-08-10 出版日期:2010-05-28 发布日期:2010-05-28
  • 通讯作者: 刘元元 E-mail:liuyuanyuan@163.com
  • 作者简介:刘元元(1961-)|女|吉林省四平市人|副教授|医学博士|主要从事肝病及其他消化系疾病的临床及基础研究。
  • 基金资助:

    国家自然科学基金资助课题(30571642)

Evaluation on curative effect of |PEG-IFN |α-2a in combination |with  |ribavirin
in treatment of |chronic hepatitis C

 LIU Yuan-Yuan, PIAO Rong-Li, XIE Chun-Yan, NIU Dun-Ai   

  1. (Department of Digestive Diseases,First Hospital,Jilin University,Changchun 130021,China)
  • Received:2009-08-10 Online:2010-05-28 Published:2010-05-28

摘要:

目的:探讨聚乙二醇干扰素(IFN)α-2a(PEG-IFNα-2a)联合利巴韦林治疗慢性丙型肝炎的效果,阐明联合用药治疗丙型肝炎的可行性。方法:86例慢性丙型肝炎患者分为治疗组38例和对照组48例。治疗组给予PEG-IFNα-2a 180 μg,每周1次皮下注射,联合利巴韦林1 000 mg,每日1次口服,共治疗2周;对照组给予IFNα-1b 50万U每日1次肌肉注射,联合利巴韦林1 000 mg,每日1次口服,共治疗24周。根据治疗前谷丙转氨酶(ALT)检测值将患者分为ALT低水平组(大于正常值但小于等于3倍正常值上限)及ALT高水平组(大于3倍正常值上限但小于等于10倍正常值上限),检测治疗前、用药12和24周及停药24周的病毒学、生化学、基因分型,比较两组间治疗结果以及ALT、HCV RNA定量及病毒学应答。结果:病毒学及生化学完全应答结果表明:在用药后24周及停药后24周时,治疗组疗效明显优于对照组(P<0.05),ALT高水平组病毒学完全应答率高于ALT低水平组(P<0.05);治
疗组ALT水平对病毒学完全应答情况无显著性影响,HCV RNA定量的水平对于对照组和治疗组的病毒学完全应答情况均无显著性影响(P>0.05)。基因分型对病毒学影响的研究表明:只有HCV-1a组与HCV-2a组在治疗结束时比较差异有显著性,HCV-2a组高于HCV-1a组(P<0.05),其他各组间比较差异均无显著性(P>0.05)。两组间不良反应发生情况相似,无明显差别。结论:长效PEG-IFNα-2a与利巴韦林联合应用是治疗慢性丙型肝炎非常有效的治疗方案,较普通干扰素能明显提高疗效。

关键词: 聚乙二醇干扰素α-2a;利巴韦林;慢性丙型肝炎

Abstract:

Abstract:Objective
To discuss the curative effect of PEG-interferon α-2a combined with ribavirin in treatment of chronic hepatitis C,and clarify the feasibility of combined therapy in treatment of chronic hepatitis C.Methods 86 cases of chronic hepatitis C patients were divided into treatment group (n=38) and  control group(n= 48).The patients in treatment group were treated with polyethylene glycol α-2a interferon 180 μg,subcutaneous injection once a week,combined with ribavirin 1 000 mg,once daily oral administration,a total of 2 weeks of treatment;the patients in control group were given α-1b interferon 500 000 U intramuscularly once a day,combined with ribavirin 1 000 mg,once daily oral administration,for 24 weeks.According to pre-treatment ALT values,all the patients were divided into low ALT group (more than normal but less than or equal to three times the upper limit of normal) and high ALT group (more than 3 times the upper limit of normal but less than or equal to 10 times the upper limit
 of normal),and the virology,biochemistry,genotyping  before treatment,12 and 24 weeks after treatment,24 weeks after withdrawl were detected and compared  between two groups,as well as ALT,HCV RNA quantitative level  and virological response.Results Virological and biochemical complete response results showed   the efficacies in the treatment group were significantly better than those in control group 24 weeks after treatment and 24 weeks after withdrawl(P<0.05);the virological complete response rate in high ALT group was higher than that in low ALT group(P<0.05);the ALT level had no significant impact on the virological complete response in treatment group,the RNA quantitative level of HCV had no significant impact  on the virological complete response in control group and treatment group(P>0.05).The study of the effect of genotype on the virology indicated that there was significant difference between 1a group and 2a group at the end of treatment (P<0.05),but there was no significant difference between the other groups(P>0.05).The adverse reactions found in two groups were similar,and there was no significant difference. Conclusion The long-acting combination of pegylated interferon and ribavirin  in treatment for chronic hepatitis C is a very effective,and it can significantly increase the efficacy than general interferon.

Key words: PEG-IFNα-2a;ribavirin;chronic hepatitis C

中图分类号: 

  • R512.64